I was interested to know if the European Community, or any surgical European society has adopted a system to evaluate surgeon results (mortality, morbidity, case complexity) efficacy and economic productivity of surgeons. Insurance U.S. health care system uses RVUs (relative value unit) to asses surgeon productivity.
Some of these data exist in Europe. But not in detail. There is a quality program called EURECCA gathering data from different countries in surgical oncology (CRC, HPB etc). As different countries have different data bases, they try to gather data and to compare results, esp. in morbidity and mortality.
In Germany - the country where I work and live- medical insurance companies try to gather all the data you mentioned, but they only have data not for a specific surgeon, but for the whole hospital or department. But in future this may change and insurance companies will have all the data
Dear Mauro
I hope these references may be useful for you
1)Health Technology Assessment report on the presurgical evaluation and surgical treatment of drug-resistant epilepsy.
Epilepsia. 2013 Oct;54 Suppl 7:49-58.
Marras CE1, Canevini MP, Colicchio G, Guerrini R, Rubboli G, Scerrati M, Spreafico R, Tassi L, LoRusso G, Tinuper P; Commission on Epilepsy Surgery of the Italian League Against Epilepsy
2)J Am Coll Surg. 2013 Mar;216(3):472-81
Measuring safety and efficiency in the operating room: development and validation of a metric for evaluating task execution in the operating room.
Russ S1, Arora S, Wharton R, Wheelock A, Hull L, Sharma E, Darzi A, Vincent C, Sevdalis N
3)J Gynecol Obstet Biol Reprod (Paris). 2010 Sep;39(5):362-70.
[Do we need a surgical safety checklist?].
Panel P1, Cabarrot P
4)nternal and external measures of quality assurance in gynecological surgery.
Selbmann HK, Geraedts M.
Eur J Obstet Gynecol Reprod Biol. 1997 Feb;71(2):223-7
In this review article for safety in surgery you can find assessment criteria for hospital or departmental care outcome, not for individual surgeon, but some of them can be used for an evaluation surgical system. In our country the national enshurance company as a monopolist dictates requrements for fulfillment of surgical pathways. The official regulative document is the national standard for general surgery, where according to resources three levels of departments exist, depending on cmplexity of care from I to III level of competence. In my oppinion it is high time to start working on paneuropean regulations/ recommenditions, guidelines/ for assessment of the individual surgical practice, based on quantitative an quality criteria. It will reflect on education of surgeons, day-practice and will be beneficial to p[atients, surgeons and society.
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